Individual
SYDNEY NICOLE LEVERETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, NREMT
Contact information
Practice address
875 PERIMETER DR, MOSCOW, ID 83844-8835
(208) 885-1673
Mailing address
175 MALACHI PATH, DALLAS, GA 30132-4446
(770) 378-3625
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
10201526
OR
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/06/2018
Last updated
08/17/2024
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